2011-2012
Bloodborne Pathogens
Information – Precautions - Procedures
An On-Line
Professional Development Course
Offered By
Bartlesville Public Schools
For
Bartlesville Public School Employees
Required Professional
Development
In accordance with the
OSHA Bloodborne Pathogens Standard
29 CFT 1910.1030
all Bartlesville Public School employees
must ANNUALLY receive
bloodborne pathogen training.
2
This self-paced course will:
• Provide information about bloodborne
pathogens (BBP) and the diseases they
can cause and
• Outline precautions and procedures you
should take to protect yourself and
others from exposure to bloodborne
illness.
3
BBP Training Objectives
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To eliminate or minimize job related exposure to
bloodborne pathogens (BBP)
To provide some information about the potential
sources of bloodborne pathogen (BBP) exposure
in the school setting
To provide some information about diseases
transmitted by bloodborne pathogens (BBP)
To review some universal precautions for limiting
exposure to bloodborne pathogens (BBP)
To review some procedure you should take if you
experience a potential bloodborne pathogen
(BBP) exposure
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Course Credit
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Throughout this course key points will be
highlighted with review questions and answers.
At the end of the course Bartlesville
Certified teachers
Certified building principals
Certified special education paraprofessionals
Other designated staff
may access a quiz to document participation in
Bloodborne Pathogens training for the period
July 1, 2011 through June 30, 2012.
5
What Are Bloodborne Pathogens?
Bloodborne Pathogens are
microorganisms such as viruses or
bacteria that are carried in blood and
can cause disease in people. These
pathogens include viral hepatitis,
human immunodeficiency virus
(AIDS), malaria, rabies, syphilis and
brucellosis.
6
Where Are They Found?

In the school setting potentially
infectious materials are most often
found in human body fluids such as:
• Blood
• Saliva
• Vomit
• Urine
• Semen
• Vaginal secretions

A blood test is required to confirm a
BBP infection.
7
Who Is At Risk of Exposure
School employees have a low to moderate risk of
exposure to bloodborne pathogens. Employees
most at risk of exposure are:
• School Nurses
• Athletic Coaches
• Custodians
• Special Education Teachers
• Regular Classroom Teachers
Because risks for exposure do exists, all Bartlesville
Public School employees must be prepared to
respond using standard precautions.
8
How Does Exposure Occur?
In the school setting potential exposure to
bloodborne pathogens occur most often from direct
contact with:
 Body fluids from the nose, mouth and eyes that
contain blood
 Bleeding wounds caused by cut, punctured and
abraded skin
 Bleeding skin conditions such as acne and athlete’s
foot
 Human bites by students
 Chronic or sudden on-set diarrhea or vomit that is
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contaminated with blood
How Does Exposure Occur?
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In the school setting exposure to bloodborne
pathogens occurs most often when you and/or an
offending party transfers infectious blood products
from their body, a surface or an object to your
mouth, eyes, nose or skin.
Skin exposure can occur through open cuts, nicks,
abrasions, dermatitis and acne.
10
Pathogens of Greatest Concern

The pathogens of primary concern
are:
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)
• Human immunodeficiency virus (HIV)
11
Hepatitis B Virus (HBV)
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Scientifically classified as Hepadnavirus
Contains deoxyribonucleic acid (DNA)
Hepatitis B virus (HBV) is 100 times more
infectious than HIV, the virus that causes AIDS
About 5% of Americans have been infected with
HBV at some point during their lifetime.
If you get infected with HBV you can also get
infected with the hepatitis D virus (HDV). If this
happens, you may become very sick.
12
Hepatitis B Virus (HBV)
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HBV is found in the blood and body fluids of an
infected person.
HBV can live for an extended time – over one
week - in dry blood and on dry surfaces.
Average incubation period (the time between the
initial exposure to the virus and the development
of symptoms of the HBV disease) is about 16
weeks.
In the school setting the most common method
of exposure is through direct contact with blood
from an open wound or from a human bite from
an infected person.
13
Chronic Hepatitis B (HBV)
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About 1.25 million people living in the United
States have chronic (life-long) HBV infection.
They might not look or feel sick.
People who have chronic HBV infection may be
“hepatitis B carriers”. They can spread HBV to
others.
About 15% to 25% of persons with chronic HBV
infection die from liver cirrhosis or liver cancer.
Chronic infections occurs in”
• 90% of infants infected with HBV at birth
• 30% of children infected between birth and 5
• 6% of people infected after age 5
14
Hepatitis B Virus (HBV) Symptoms
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Not everyone will present symptoms.
Adults and teens will have symptoms more often
than young children.
Symptoms you my experience:
• Tiredness
• Loss of appetite
• Fever
• Diarrhea
• Dark urine
• Light-colored stools
• Jaundice (yellow skin and eyes)
15
Hepatitis B Virus (HBV) Vaccine
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Hepatitis vaccines are safe and effective. Adult
protection will last for up to 15 years.
Hepatitis B vaccine is recommended for :
• All infants
• All children and adolescents
• School employees in higher risk job assignments
- School Nurses
- Athletic Coaches
- Special Education Teachers
Hepatitis B vaccine for adults is usually given as
three shots over a 4-6 month period.
16
Hepatitis B Prevention
In the school setting
 The most effective way to prevent exposure to
the Hepatitis B virus is to wear gloves if you have
to touch anyone’s blood.
 If your skin is exposed to blood or body fluids,
immediately wash the exposed area with soap
and water
 Flush exposed eyes, mouth or nose with water
for at least 15 minutes.
 If you are exposed to blood or body fluids file an
exposure report with your immediate supervisor
and request the Hepatitis B vaccine.
17
Hepatitis B Treatment
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There is not treatment for acute (new infection)
hepatitis B
For chronic (life-long) hepatitis B, antiviral
medicines are available:
• Treatment may take as long as a year
• Medicines are effective in reducing liver
damage in about one-half of patients.
Liver transplant
• Over time your liver may stop working and you
may need a new liver from a donor
18
Hepatitis C Virus (HCV)
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Scientifically classified as Flavivirus
Contains ribonucleic acid (RNA)
Approximately 4 million American have been
infected with hepatitis C virus (HCV)
8,000 – 10,000 Americans die from HCV-related
illness each year
Chronic liver disease, caused by HCV is the #1
reason for liver transplantation in the U.S.
19
Hepatitis C Virus (HCV)
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HCV is found in the blood and body fluids of an
infected person.
Average incubation period (the time between the
initial exposure to the virus and the development
of symptoms of the HCV disease) is 7 to 9 weeks.
In the school setting the most common method
of exposure is through direct contact with blood
from an open wound or from sharing items that
have blood on them
20
Hepatitis C Virus (HCV) Symptoms
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Not everyone will have symptoms.
Adults and teens will have symptoms more often
than young children.
Symptoms you my experience:
• Tiredness
• Loss of appetite
• Fever
• Stomach ache
• Diarrhea
• Dark urine
• Light-colored stools
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• Jaundice (yellow skin and eyes)
Hepatitis C Prevention
In the school setting
 The most effective way to prevent exposure to
the Hepatitis C virus is to wear gloves if you have
to touch anyone’s blood.
 Do not share items that may have blood on them
 If your skin is exposed to blood or body fluids,
immediately wash the exposed area with soap
and water
 Flush exposed eyes, mouth or nose with water
for at least 15 minutes.
 If you are exposed to blood or body fluids file an
exposure report with your immediate supervisor.
22
Hepatitis C Treatment
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There is no treatment for acute (new infection)
hepatitis C
For chronic (life-long) hepatitis C, antiviral
medicines are available:
• Treatment may take as long as a year
• With treatment about 50% of patients get rid
of the virus
Liver transplant
• Over time your liver may stop working and you
may need a liver transplant
23
Human Immunodeficiency Virus (HIV)
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HIV is a bloodborne infectious disease
The human immunodeficiency virus (HIV) is most
likely the cause of acquired immune deficiency
syndrome (AIDS)
Once a person has been infected with HIV, it may
be several years before AIDS actually develops
HIV attacks and weakens the body’s immune
system
AIDS is a fatal disease
In the school setting the most likely way for
transmitting HIV is through contact with infected
human blood and any body fluid visibly
contaminated with blood
24
Stages of HIV/AIDS
HIV/AIDS infection occurs in three broad stages
 First Stage
• Begins when a person is first infected with the
human immunodeficiency virus (HIV)
• The infected person may experience a brief,
mild flu-like illness shortly after infection
• After the initial infection, a person may show
few or no signs of illness for many years
• The latency period may last from 7 to 12 years
from infection to the development of AIDS
25
Stages of HIV/AIDS
HIV/AIDS infection occurs in three broad stages
 Second Stage
• Starts when the infected person begins to
experience frequent respiratory ailments and
suffer from swollen lymph glands and other
conditions that take advantage of the body’s
weakened immune system
• As the second stage progresses bouts with
illness become more frequent and severe
• It is believed that during the second stage HIV
transitions to AIDS
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Stages of HIV/AIDS
HIV/AIDS infection occurs in three broad stages
 Third Stage
• The body becomes progressively unable to
fight off infections
• The immune system is severely weakened and
life threatening diseases become a major
concern
• A person infected with AIDS is more likely to
die from a disease that takes advantage of the
body’s weakened immune system than from
the human immunodeficiency virus
27
HIV/AIDS Symptoms
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An infected person can pass on the HIV infection
before symptoms appear
Symptoms of HIV infection can vary and often
include:
• Physical weakness
• Fever and sore throat
• Nausea
• Headaches
• Diarrhea
• Thrush (a fungal infection of the mouth)
• Weight loss
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• Swollen lymph glands
HIV/AIDS Prevention
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HIV is a fragile virus and will not survive for long
outside the human body
In the school setting, the most effective way to
prevent exposure to HIV is to:
• Practice and use universal precautions
• use appropriate protective equipment including
gloves if you have to touch blood or body
fluids contaminated with blood
• Properly dispose of any materials
contaminated with blood and other body fluids.
• Document and report any potential exposure
to your immediate supervisor immediately
29
HIV/AIDS Prevention


In the school setting, those most at risk of HIV
infection are:
• School nurses
• Custodians
• Special education teachers
• Regular Classroom teachers
Exposure and transmission are most likely to
occur while:
• Providing first aid to students
• Cleaning up vomit and blood in bathrooms,
hallways and classrooms
30
HIV/AIDS Treatment
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There is no known cure for HIV/AIDS
Persons infected with HIV/AIDS should take
precautions to prevent exposure to diseases that
may further weaken their immune system
Anti-retroviral therapies can reduce the number
of viral organisms in the blood of an infected
person to below detectable levels, usually within
4 to 6 weeks (This does not mean the person is
“cured of HIV”.)
31
Standard Precautions/Risk Reduction
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“Standard precautions” are procedures used to
reduce risks of exposure to bloodborne
pathogens
In applying standard precautions, you should
always treat blood and body fluids “as if they are
infectious materials”
Standard precautions should be used even when
you think there is no risk involved
The use of standard precautions will help to
protect Bartlesville Public School employees and
our students from contact with infectious agents.
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Standard Precautions/Risk Reduction
Bartlesville school employees should know and use
the following standard precautions for risk reduction:
 Hand Hygiene
 Disposal of sharps and glass
 Decontamination of surfaces
 Disposal of materials contaminated with blood and
body fluids
 Document all exposure incidents
 Request hepatitis B vaccine
33
Standard Precautions – Hand Hygiene
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The single most effective way to prevent
bloodborne pathogen exposure in the school
setting is to use standard precaution hand hygiene
including:
• Hand washing using soap and water
• Hand washing using alcohol-based hand rubs
• Proper use of protective gloves
Even if your hands appear to be clean, the process
of providing first aid or cleaning up a contaminated
area may lead to hand contamination
34
Hand Hygiene – Soap & Water
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Use soap and water to clean hands when:
• Hands are visibly dirty
• Hands have been contaminated with blood or
body fluids
• You have handled contaminated materials
• You remove protective gloves
Liquid soap is preferred to bar soap
Warm or tepid water is preferred to cold water
Running water is preferred to a bowl of water
35
Hand Hygiene – Soap & Water
The Center for Disease Control recommends the
following hand washing method for soap and water:
 Wet hands with water
 Apply a quarter size dollop of liquid hand soap to
the palm of one hand
 Rub hands together for at least 15 seconds,
covering all surfaces , focusing on fingertips and
fingernails
 Do not use a scrub brush
 Rinse under running water
 Dry with a disposable towel
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 Use towel to turn off the faucet
Hand Hygiene – Alcohol Rubs
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Alcohol-based hand rubs (foam or gel) are more
effective in killing bacteria than soap and water
Alcohol-based hand rubs are less damaging to the
skin than soap and water, resulting in less dryness
and irritation.
Alcohol-based hand rubs require less time than
hand washing with soap and water
Alcohol-based hand rubs can be placed at the point
of need so they are more accessible
Alcohol-based hand rubs are the preferred method
for hand hygiene in all situations except:
• When hands are visibly dirty
• Hands have been contaminated with blood or 37
body fluids
Hand Hygiene – Alcohol Rubs
The Center for Disease Control recommends the
following hand washing method for alcohol rubs:
 Apply to palm of one hand the amount of rub
recommended on the label
 Rub hands together covering all surfaces , focusing
on fingertips and fingernails until hands are dry
 Use enough rub to require at least 15 seconds for
hands to dry
38
Hand Hygiene - Gloves
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Gloves should be used when hands may become
contaminated with blood or body fluids, or when
touching contaminated surfaces or objects
Common problems with glove use in a school
setting are failure to:
• Wear gloves when touching an open wound
• Wear gloves when touching items that are likely
to be contaminated with blood or body fluids
• Change gloves between students
• Change gloves if a tear or puncture occurs
• Remove gloves after problem is mitigated
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Hand Hygiene - Gloves
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Gloves should be made of latex, nitril, rubber or
other water impervious materials
Put gloves on without touching the inside of the
glove except with the skin of your hand
Remove gloves carefully so the outside of the
glove does not touch your bare hand or other skin
Dispose of used gloves in a container reserved for
contaminated item, so no one can come in contact
with them
Do not reuse or wash disposable gloves
Use standard precaution hand hygiene to wash
hands immediately after removing gloves
40
Standard Precautions – Needles
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Needles should never be recapped, broken or
sheared
Needles should only be disposed of in labeled
sharps containers
Sharps containers should be closable, punctureresistant, leak proof on the sides and bottom and
must be labeled
Sharps containers should have a secure, closable
cover to prevent spillage when handled
All needles should be handled as contaminated
material
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Standard Precautions – Glass
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Broken glassware that has been visibly
contaminated with blood or other body fluids must
be sterilized with an approved disinfectant solution
before it is disturbed or cleaned up. (See your
custodian for appropriate disinfectant)
Broken glassware that has be decontaminated may
be disposed of in an appropriate sharps container –
closable, puncture-resistant, leak proof on sides
and bottom and labeled
Broken glass must be swept or brushed into a dust
pan. Broken glass must never be picked up
directly with the hands
42
Standard Precautions – Surfaces
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All surfaces – floors, tables, books, etc – that come
in contact with blood or potentially infectious
materials must be decontaminated as soon as
possible and before the surface is returned to
normal use.
Building custodians have received specialized
training and can help you with surface
decontamination
If the building custodian is not available and you
have not received specialized training in surface
democratization, restrict access to the
contaminated area until the custodian can
43
decontaminate the area
Standard Precautions – Disposal of
Contaminated Materials
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All materials contaminated with blood or body
fluids should be handled as regulated waste
Regulated waste should be disposed of in properly
labeled containers or red biohazard bags.
Building custodians have received training in how
to dispose of contaminated materials.
Non regulated waste may be disposed of in regular
plastic trash bags
44
Standard Precautions – Post
Exposure Follow-Up
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Any Bartlesville Public School employee who
experiences a potential bloodborne pathogen
exposure shall document and report the incident.
The employee shall document:
• The time and location of the incident
• The parties involved in the incident
• How the exposure occurred
• The standard precautions followed to mitigate
the incident
The employee shall report the incident to their
immediate supervisor.
45
Standard Precautions – Hepatitis B
Vaccine
A Hepatitis B vaccine shall be available to any
employee who experiences a potential exposure to
bloodborne pathogens. The following conditions
may qualify as exceptions:
• The employee has previously received the
complete Hepatitis B vaccination series
• Antibody testing reveals that the employee is
immune
• The vaccine is contraindicated for medical
reasons
• The employee declines the vaccination
46
Hepatitis B Vaccination Refusal
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If an employee initially declines the
Hepatitis B vaccination; but later decides
to accept the vaccination, the vaccination
shall then be made available.
If an employee declines the Hepatitis B
vaccination when offered, the employee
shall be required to sign the OSHA
required waiver indicating their refusal.
47
Bloodborne Pathogen Exposure
Control Plan
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Each school site is required to have a written
Bloodborne Pathogen Exposure Control Plan. The
plan must include:
•
•
•
•
•
Purpose of plan
Scope (who is at risk of exposure)
Responsibilities (job assignments)
Training schedule and content
Engineering and work controls (procedures for limiting
exposure)
• Procedures for reporting incidents and potential
exposure
• Procedure for requesting Hepatitis B vaccine

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The plan must be accessible to all employees
The plan must be reviewed and up-dated at least
annually
48
Responsibility of Principals
Principals shall have the responsibility for ensuring
that all employees in their building
 Receive Bloodborne Pathogen training annually
 Have access to necessary supplies to protect
themselves and all students including
•
•
•
•
•
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Gloves and protective equipment
Soap
Bleach and disinfecting agents
Brooms and dust pans
Appropriate disposal containers
Practice universal precaution hand hygiene
Have access to Hepatitis B vaccinations if
exposure occurs
Report potential exposures to Human Resources
Monitor building Bloodborne Pathogen Exposure
Control Plan
49
Responsibilities of Teachers and
Other Building Staff
Teachers and other building staff shall have the
responsibility for:
 Participating in Bloodborne Pathogen training
annually
 Knowing where protective supplies are kept
 Knowing how to protect themselves and all
students in the building from potential
bloodborne pathogen exposure
 Practicing universal precaution hand hygiene
 Helping students practice universal precaution
hand hygiene
 Reporting potential bloodborne pathogen
exposures to the principal
 Requesting a Hepatitis B vaccine if potential
exposure to bloodborne pathogens has occurred
50
Responsibilities of Building
Custodians
Building custodians receive specialized training for
cleaning up and disposing of potentially infectious
materials. Ask your building custodian for help:
 When cleaning up potentially infectious bodily
fluids such as blood, vomit and urine
 In disinfecting surfaces contaminated with
potentially infectious bodily fluids such as blood,
vomit and urine
 When disposing of cleaning materials
contaminated with potentially infectious bodily
fluids such as blood, vomit and urine
51
Responsibilities of School Nurses
and First Aid Responders
School nurses and first aid responders receive
specialized training for assisting teachers and
students with open wounds and chronic and sudden
on-set illness. Ask your school nurse or first aid
responders for help:
 When you or a student needs treatment for an
open wound
 When you or a student experience loss of blood,
vomit or urine in the classroom, in the school
building or on school property
52
Course Review

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

Bloodborne pathogens are microorganisms such
as virus and bacteria that are carried in blood
and body fluids and can cause disease in people.
Bloodborne pathogens are found in human body
fluids such as blood, saliva, vomit, and urine.
School employees have a low to moderate risk of
exposure to bloodborne pathogens. Employees
most at risk are school nurses, athletic coaches,
custodians, special education teachers and
classroom teachers.
Exposure to bloodborne pathogens can occur
when contaminated blood comes in contact with
open cuts, skin nicks, abrasions, dermatitis, acne
and athletes foot.
53
Course Review

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Bloodborne pathogens of greatest concern in the
school setting are hepatitis B, hepatitis C and
HIV.
Hepatitis vaccine is safe and effective. Adult
protection can last up to 15 years.
Teachers who are exposed to blood or body fluids
should file an exposure report with their principal
and request a hepatitis B vaccine.
Hepatitis B virus is many times more infectious
than HIV or hepatitis C virus.
“Standard precautions” are procedures used to
reduce risks of exposure to bloodborne
pathogens.
54
Course Review

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
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Standard precaution hand hygiene is the single
most effective way to prevent bloodborne
pathogen exposure in schools.
Hands should be rubbed together with soap for at
least 15 seconds when using soap and water to
wash hands
Alcohol-based rubs are more effective in killing
bacteria than soap and water.
When using alcohol-based rubs to clean hands
you should use enough gel or foam to rub hands
for at least 15 seconds before they dry.
55
Course Review

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
Gloves should be used when hands may become
contaminated with blood or body fluids or when
touching contaminated surfaces or objects.
All surfaces including floors, tables and books
that come into contact with blood or body fluids
should be decontaminated before returned to
normal use.
Any teacher who experiences a potential
bloodborne pathogen exposure should document
the incident and report it to their principal.
All Bartlesville Public School employees are
required to participate in bloodborne pathogen
training at least once a year.
56
Resources
Lisa Foreman, B.S.N., R.N.
District School Nurse
E-mail – ForemanLE@bps-ok.org
Check with Nurse Lisa if you have questions or
need information about:
Bloodborne pathogens
Hepatitis, HIV/AIDS
Standard precautions, Hand hygiene
Hepatitis B vaccine
57
Active Web Links to Resources



The following active web links will take
you to original source documents where
you can find additional information about
bloodborne pathogens, diseases caused by
BBPs and workplace law.
For the links to activate, the screen must
be maximized.
If you are unable to activate a link, copy
the link and paste it in your web browser.
58
Resources
Check the Center for Disease Control (CDC)
web-site for additional information about:
bloodborne pathogens
Hepatitis
HIV/AIDS
Standard precautions
Hand hygiene
http://www.cdc.gov
Type “bloodborne Pathogens” in the search box.
59
Resources
Check the US Department of Labor web-site for
additional information about:
Bloodborne Pathogen Standards
http://frwebgate.access.gpo.gov/cgi-bin/getcfr.cgi?TITLE=29&PART=1910&SECTION=1030&T
YPE=TEXT
http://www.osha.gov/pls/oshaweb/owadisp.show_
document?p_table=STANDARDS&p_id=10051
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You have completed the study portion of the
2011-2012
Bloodborne Pathogens
Information – Precautions – Procedures
On-Line Professional Development Course
To Receive Professional Development Credit
Click the link below to access the
Bloodborne Pathogen Quiz
https://www.surveymonkey.com/s/YYTBTSS
Note: The screen must be maximized for the link to be active.
Note: If you are unable to activate the link to the quiz,
copy the link and paste it in your browser.
61